Table 3.
Estimates of mean cost (UK £ sterling, 2018/19) by treatment group over 12-month treatment period for all patients (based on available data)
| Cost component | Craniotomy (N=126) | DC (N=122) | P value* |
| Hospital-recorded, index admission | |||
| Index neurosurgical procedure, mean cost±SD | 3648±1264 (n=122) | 3560±1315 (n=110) | 0.603 |
| Length of stay in NSU (index admission), mean cost±SD | 6109±9085 (n=122) | 7766±11 339 (n=120) | 0.210 |
| Length of stay in ICU (index admission), mean cost±SD | 20 039±14 566 (n=126) | 22 873±19 077 (n=122) | 0.189 |
| Further DCs (index admission), mean cost±SD† | 307±859 (n=116) | 82±536 (n=116) | 0.017 |
| Further haematoma evacuations (index admission), mean cost±SD | 165±638 (n=116) | 37±279 (n=116) | 0.048 |
| Further wound revision (index admission), mean cost±SD | 18±198 (n=116) | 110±551 (n=116) | 0.092 |
| Further other cranial operations (index admission),‡ mean cost±SD | 55±340 (n=116) | 37±279 (n=116) | 0.653 |
| Total cost per patient (index admission), mean cost±SD | 30 790±19 710 (n=109) | 34 759±24 481 (n=102) | 0.195 |
| Hospital-recorded cranioplasties and shunts (index admission and postdischarge) | |||
| Cranioplasty procedures, mean cost±SD | 1059±2485 (n=124) | 3055±3352 (n=122) | <0.0001 |
| Shunt procedures, mean cost±SD | 212±1121 (n=126) | 150±834 (n=118) | 0.626 |
| Cranioplasty/shunt same day discount, mean cost±SD§ | −17±132 (n=124) | 0±0 (n=118) | 0.167 |
| Total cost per patient (cranioplasties and shunts), mean cost±SD | 1258±2983 (n=124) | 3228±3677 (n=118) | <0.0001 |
| Patient-reported, postdischarge | |||
| Overnight stays on rehabilitation unit, mean cost±SD¶ | 16 375±31 784 (n=111) | 17 677±34 660 (n=90) | 0.782 |
| Overnight stays on NSU, mean cost±SD¶ | 177±729 (n=111) | 415±2029 (n=95) | 0.252 |
| Overnight stays on ICU/HDU, mean cost±SD¶ | 213±2247 (n=111) | 125±1215 (n=95) | 0.731 |
| Overnight stays on ‘other’ ward, mean cost±SD¶ | 1746±6396 (n=109) | 1076±6015 (n=93) | 0.447 |
| All healthcare professional visits, mean cost±SD | 682±1108 (n=103) | 782±1578 (n=88) | 0.612 |
| All head/brain scans, mean cost±SD | 66±105 (n=111) | 93±101 (n=93) | 0.436 |
| Total cost per patient (postdischarge PSRQ), mean cost±SD | 19 699±34 193 (n=99) | 17 948±32 183 (n=81) | 0.726 |
| Time in a care home (wider perspective only), mean cost±SD | 3321±13 230 (n=109) | 6550±19 272 (n=91) | 0.164 |
| Carer time (wider perspective only), mean cost±SD | 16 762±34 828 (n=99) | 17 271±38 419 (n=86) | 0.925 |
| Overall NHS and PSS cost per patient, mean cost±SD | 48 509±46 934 (n=86) | 53 573±47 092 (n=67) | 0.510 |
*For the mean cost difference between groups.
†Based on mean duration of DC (from all index procedures) of 2.50 (n=110) hours for all randomised patients.
‡Excluding cranioplasties and shunts.
§A discount was applied to account for those shunt and cranioplasty procedures that occurred on the same day and were therefore assumed to be associated with a slightly shorter operation duration and NSU stay.
¶Overnight stays excluding those associated with a skull/brain operation.
DC, decompressive craniectomy; HDU, High Dependency Unit; ICU, intensive care unit; n, number of patients for whom data were available; N, number allocated to that trial arm; NHS, National Health Service; NSU, neurosurgical unit; PSRQ, Patient Self-Report Questionnaire; PSS, Personal Social Services; SD, standard deviation.